In Canada, prisoners face far greater risk of HIV and hepatitis C virus (HCV) infection because those who inject drugs are denied access to sterile needles and syringes — tools that are widely available outside prison so people are not forced to share equipment. Most federal prisoners in Canada will return home to their communities, bringing with them the illnesses they contract in prison. This, in turn, can affect us all.

Simply put, prison health is community health.

Prison needle and syringe programs (PNSPs) don’t just protect prisoners from infection. They would also protect the health and lives of all Canadians. Despite overwhelming evidence of the benefits of PNSPs from numerous countries around the world that have successfully implemented them, no Canadian prison currently permits access to sterile injection equipment. Calls for the Government of Canada to introduce these important harm reduction measures have been ignored.

But no more. On September 25, 2012, a former prisoner, community partners and the Canadian HIV/AIDS Legal Network launched a lawsuit against the Government of Canada over its failure to protect prisoners’ right to health and prevent the spread of HIV and HCV in Canadian federal prisons.

Follow the links above to learn more about prisoners’ right to health, PNSPs, the lawsuit and how to get involved in the campaign.

Updates

Why no needle and syringe program in our federal prisons, Mr. Trudeau?

November 1, 2017 — Five years ago, the Canadian HIV/AIDS Legal Network joined co-applicants in a constitutional court case seeking the implementation of needle and syringe programs in federal prisons. These programs could prevent numerous new HIV and Hepatitis C virus infections each year, saving tens of millions of dollars.

Despite the Trudeau government's commitment to harm reduction and evidence-based policy, the federal government continues to drag its feet.

The Legal Network's director of research and advocacy, Sandra Ka Hon Chu, and executive director Richard Elliott were recently published in the Ottawa Citizen, making the case for these necessary programs and calling on the federal government to implement them immediately. Read the piece on the Ottawa Citizen's website.

Open letter and brief to Prime Minister Trudeau and cabinet ministers

October 27, 2017 — The Legal Network recently wrote to Prime Minister Justin Trudeau and other ministers in the federal cabinet on behalf of the co-applicants. Visit the About the Lawsuit page to see the open letter and documents in the brief.

October 12, 2017 — In its Concluding Observations on its review of Canada, the UN Committee on the Elimination of Racial Discrimination expressed serious concern about the disproportinately high rate of incarceration of Indigenous and Black people for drug crimes in Canada — a violation of the government’s obligations under the International Convention on the Elimination of All Forms of Racial Discrimination. The expert body called on Canada to re-examine its drug policies and provide evidence-based alternatives to incarceration for non-violent drug users.

insights on prison needle and syringe programs: research with former prisoners in canada

October 12, 2017 — Despite the frequent occurrence of injection drug use in Canada's federal prisons, the correctional service does not allow prisoners access to sterile injection equipment as a harm reduction measure. Emily van der Meulen, Tara Marie Watson and Ann de Shalit present qualitative data from a community-driven study with 30 former prisoners in Ontario, Canada, in which participants shared insights that are valuable for understanding the prison context in relation to the need for prison-based needle and syringe programs in Canada and other jurisdictions.

THE CONSTITUTIONAL CHALLENGE FOR PRISON-BASED NEEDLE AND SYRINGE PROGRAMS: AN UPDATE

May 3, 2017 — During the last federal election, in response to a questionnaire that the Legal Network sent to the five major parties asking their position on key questions related to HIV and human rights, the Liberal Party of Canada indicated that there is "compelling evidence" for prison-based needle and syringe programs (PNSPs). They promised to “carefully review statements” by the Legal Network and others contending that prisoners’ constitutional rights are being violated by the failure to provide such programs inside prisons.

This promise, coupled with the Liberal government’s explicit commitment to “evidence-based policies” and harm reduction, made mediation — and thus the possibility of reaching a successful outcome (i.e., the implementation of PNSPs in federal prisons) more quickly and effectively — an attractive option to resolve our outstanding lawsuit. The applicants raised the possibility of mediation, which is an attempt to settle a dispute with the assistance of a neutral third party, outside a courtroom.

The government agreed, a mediator was secured, and mediation was to begin on January 23, 2017. After four years of litigation and 20 years of advocacy, the prospect of actually implementing life-saving PNSPs seemed within reach.

In the meantime, we continue to carry on with the lawsuit. Cross-examinations will begin in the coming months, and a hearing is scheduled to take place before the end of the year. We will also continue to advocate for PNSPs with federal policy makers. Earlier this month, at Canada's Drug Futures Forum in Ottawa, we asked the Minister of Health Dr. Jane Philpott about scaling up harm reduction in prisons, including access to sterile injection equipment. Minister Philpott responded by pointing to pilot projects as a step to move PNSPs forward. You can see the exchange on the Drug Future Forum’s Facebook page, with the clip beginning around the 41:15 mark. While the federal government’s decision to withdraw from mediation was a profound disappointment, it did not dissuade us from working with our co-applicants to uphold the human rights of people in prison. We will continue the fight for PNSPs, no matter how long it takes.

“It Goes on Everywhere”: STUDY ON Injection Drug Use in Canadian Federal Prisons

February 22, 2017 — International and Canadian research on in-prison injection drug use has documented the frequency of its occurrence as well as some of the resulting consequences such as increased prevalence of HIV and hepatitis C virus. Access to prison-based harm reduction programming is thus important. The aim of this study conducted by Emily van der Meulen, PhD, Associate Professor at Ryerson University's Department of Criminology, was to learn from former prisoner experiences and insights on in-prison injection drug use in order to advance and improve access to harm reduction options, in particular prison-based needle and syringe programs (PNSPs).

Read the abstract of “It Goes on Everywhere”: Injection Drug Use in Canadian Federal Prisons. If you would like a full copy of the study, please e-mail Emily van der Meulen at evandermeulen@ryerson.ca.

COMMITTEE ON THE ELIMINATION OF DISCRIMINATION AGAINST WOMEN ISSUES CONCLUDING OBSERVATIONS

November 2016 — Last year, the Legal Network made submissions to the Committee on the Elimination of Discrimination against Women (CEDAW Committee), a body of independent experts appointed by UN Member States that monitors implementation of the Convention on the Elimination of All Forms of Discrimination against Women, on its compliance with the Convention, urging it to recommend, among other things, the implementation of prison-based needle and syringe programs in Canada’s prisons. We also attended the Committee’s review of Canada in Geneva in order to advocate for the Committee’s inclusion of our recommendations. In November 2016, the Committee released its concluding observations on the combined eighth and ninth periodic reports of Canada.

In its concluding observations, the CEDAW Committee expressed concern about “the excessive use of incarceration as a drug-control measure against women and the ensuing female over-population in prison” and acknowledged “high rates of HIV/AIDS among female inmates.” The CEDAW Committee also recommended that Canada “Expand care, treatment and support services to women in detention living with or vulnerable to HIV/AIDS, including by implementing prison-based needle and syringe programmes, opioid substitution therapy, condoms and other safer sex supplies.” This is an historic recommendation, and the first time an international human rights review body has urged Canada to introduce needle and syringe programs in prisons. The Committee’s ground-breaking affirmation of these programs will be most helpful as we continue to push for these programs with the federal government. For more of our commentary on the CEDAW Committee’s recommendations, see here.

June 1, 2016 — Close to 250 Canadian organizations have signed a statement urging federal and provincial governments to immediately implement prison-based needle and syringe programs (PNSPs) in institutions across the country. Representing the views of a broad cross-section of Canadian civil society, the statement highlights the overwhelming scientific, empirical and human rights rationale for Canada’s governments to act without delay.

On Point: Recommendations for Prison-Based Needle and Syringe Programs in Canada

February 3, 2016

This report is the culmination of a multi-phase, multi-year undertaking that involved broad consultation and primary research to create recommendations for implementing prison-based needle and syringe programs (PNSPs), which provide sterile injection equipment to prisoners who inject drugs and help prevent the spread of HIV and hepatitis C virus (HCV), in Canadian federal prisons.

The report highlights three phases of the research project — a stakeholder meeting (phase 1), prison site visits in Switzerland (phase 2), and a community-based research project (phase 3) — and concludes with six recommendations on how PNSPs can and should be implemented in Canadian prisons without delay.

This is the fifth in a series of blog posts being published by the Canadian HIV/AIDS Legal Network ahead of Election Day on October 19, 2015. Recently, the Legal Network sent a questionnaire to the five major federal parties, asking their position on key questions related to HIV and human rights. Four out of five parties responded. Their responses are shared here, along with the Legan Network's comments.

Across Canada, publicly funded needle and syringe programs help prevent the spread of infectious diseases, including HIV and hepatitis C (HCV). But these programs do not exist inside Canadian prisons — even though the federal government’s own research shows that drugs get into prisons despite efforts to block them, and that many people in prison struggle with addiction and inject drugs, including by sharing makeshift injection equipment.

In Canada, the prevalence of HIV and HCV infection among people in prison is at least 10 and 30 times higher, respectively, than in the overall population. If implemented, prison needle and syringe programs (PNSPs) would give people in prison access to the same health services available outside prisons, and also make workplaces safer for prison staff by reducing the likelihood of accidental injuries via non-sterile injection equipment shared by many people.

Despite the overwhelming evidence of the benefits of PNSPs around the world, no Canadian prison currently permits the distribution of sterile injection equipment to prisoners. This continuing failure of Canada’s lawmakers and prison authorities undermines the health of prisoners, violates human rights and leads to significant, avoidable costs of treating HIV and HCV infections that could have been prevented. Because most people in prison eventually return to the community, the health of prisoners is also a broader public health concern.

We asked the major political parties whether they would support the implementation of PNSPs in Canada’s federal prisons.

All four parties that responded were in favour of harm reduction programs, with varying degrees of clear commitment.

The New Democratic Party explicitly stated its support: “New Democrats believe that harm reduction does not stop at the prison gate. And protecting the health and lives of prisoners, prison staff and, in the longer term, the public-at-large by eliminating the transfer of infectious diseases is a question of harm reduction and should be dealt with as such. In this respect, all the proven, scientifically-based benefits of needle and syringe programs apply inside prisons as much as in the community. An NDP government will support the implementation of such programs. Denying these programs constitutes a needless risk to human health and is bad public policy.”

The Green Party was also direct and unequivocal in its support: “Yes. Harm reduction practices work — and they are desperately needed in our increasingly overcrowded prisons. Prisoners’ rights are human rights. Prisoners do not forfeit their right to health care just because they have committed a crime. In fact, their unique needs and risk factors for addiction and other health challenges warrant specialized health services, including prison needle and syringe programs in Canada’s federal prisons.” (The Green Party also shared its criticism of mandatory minimum prison sentences, poor prison conditions such as over-crowding and solitary confinement, and other ideas for improving correctional policy.)

The Liberal Party stated that “[w]e recognize that there is compelling evidence to support needle and syringe programs (NSP) in prisons,” and adding that “any changes must rely on evidence to demonstrate that [harm reduction programs] are necessary to ensure Canadians’ safety.” The Liberal Party promised to “carefully review statements by groups like the Canadian HIV/AIDS Legal Network that the Conservative government is violating the rights of inmates under the Canadian Charter of Rights and Freedoms by failing to provide prison needle and syringe programs inside prisons.”

The Conservative Party of Canada did not respond to the questionnaire.

Needle and syringe programs in prison: Why?

June 9, 2015

When we call on the Government of Canada to protect prisoners’ right to health by introducing prison-based needle and syringe programs, it is essential that the voices of people living in Canadian prisons be heard. Jarrod, a current federal prisoner, writes about how the Canadian government is failing to protect its prison population and must act now to address this life-and-death issue.

Needle and syringe programs in prison: Why?
By Jarrod G. Shook

Why would you give someone in prison a needle? Didn't we put people in prison because they broke the law? And aren't drugs illegal? So why would we give prisoners the equipment they need for intravenous drug use? Wait ... why are there drugs in prison at all?

I will admit that, at first glance, the idea of a [prison needle and syringe] program does seem bizarre, even absurd, to me, and I am a prisoner. I can just imagine how someone with no familiarity with life behind the wall would react to such a suggestion. Read more.

On April 30, 2015,the Canadian HIV/AIDS Legal Network co-hosted an ancillary event on this topic at the Annual Canadian Conference on HIV/AIDS Research (CAHR), along with the Canadian Aboriginal AIDS Network (CAAN), Native Youth Sexual Health Network, Prisoners with HIV/AIDS Support Action Network (PASAN), and Ryerson University’s Department of Criminology. Read more about the event here.

A closer look at harm reduction in prison: why PNSPs are best practices

February 10, 2015

Emily van der Meulen and the Legal Network’s Sandra Ka Hon Chu have published an important article calling much-needed attention to prison-based needle and syringe programs in the Canadian prison system as harm reduction best practice.

New commentaries on harm reduction in Canadian prisons

February 10, 2015

Tara Marie Watson’s posts in a three-part series highlight the critical need to consider policy and program reform relating to harm reduction in Canadian federal prisons. Watson has longstanding interests in drug policy and correctional populations, and research experience related to public health programming for people who use drugs.

Recently, correctional investigator Howard Sapers tabled his annual report on the state of Canadian prisons. Importantly, the report focused on the "varied, complex and extensive" needs of prisoners, both current and former, and how the Correctional Service of Canada (CSC) meets or fails to meet these needs. Given the intersecting burdens of an ideologically misguided "war on drugs" (often aptly described as a war on people who use drugs) and a recent political penchant for incarceration, Sapers points to some critical realities facing our prison population, their health and human rights. The picture isn't pretty.

Subject: The politics of harm reduction in federal prisons

November 11, 2014

In correctional facilities across Canada, there is an identified need for prison needle and syringe programs (PNSPs). The Correctional Service of Canada has barriers in place so that PNSPs currently cannot operate within the federal prison system. In “The politics of harm reduction in federal prisons,” Tara Marie Watson examines these political barriers

By Tara Marie Watson
Centre for Criminology and Sociolegal Studies, University of Toronto

Abstract

Background: We need to understand better the political barriers to prison-based harm reduction programs. In this paper, I examine the situation in the Correctional Service of Canada (CSC), a federal prison agency with a zero-tolerance drug policy and general opposition to prison needle and syringe programs (PNSPs) and safer tattooing initiatives.

Methods: This study draws on 16 interviews with former CSC senior officials, former frontline staff, and external stakeholders; CSC policy and practice documents; and testimony from a House of Commons Standing Committee public study. Thematic coding and comparison of texts were used to examine emergent themes of interest.

Results: Four interrelated issues were central for understanding the political barriers: a narrower definition of harm reduction used in corrections, both in principle and practice; the Conservative government’s tough-on-crime agenda; strong union opposition; and stakeholder perceptions that political constraints will likely persist, including the view that litigation may offer the only way to introduce PNSPs.

Conclusion: The system is at an impasse and key questions remain about the importability of harm reduction services into federal prisons. Despite a highly challenging policy environment, moving forward will demand asking new, critical questions and devising more strategic ways of entering the political-operational dialogue that opposes evidence-based programs.

On Point: Making Prison Needle and Syringe Programs Work in Canada

On Point: Making Prison Needle and Syringe Programs Work in Canada, co-hosted by prison health advocates and Ryerson University on January 23, 2014, was a lively panel discussion on the reasons prison needle and syringe programs are essential, and why prisoners’ right to health – in Canada and around the world – matters. Using strong examples from other countries’ prison needle and syringe programs, experts showed how Canada could learn from these success stories.

Please watch each of the On Point speakers (Daniela De Santis - Hindelbank Prison, Switzerland; Ruth Elwood Martin - University of British Columbia, Vancouver; Sandra Ka Hon Chu - Canadian HIV/AIDS Legal Network, Toronto; and Julie Thomas - Healing Our Nations, Nova Scotia) below. Some of their PowerPoint presentations are also included. Many thanks to the OHTN for video-recording the event, and to CATIE for editing the videos.

On Point with Julie Thomas, Healing Our Nations, Nova Scotia

On Point with Sandra Ka Hon Chu, Canadian HIV/AIDS Legal Network, Toronto

On Point with Ruth Elwood Martin, University of British Columbia, Vancouver

“It's easy to become addicted to drugs in prison because of the negative atmosphere. People feel depressed and it's an escape from reality.”

The Canadian HIV/AIDS Legal Network (www.aidslaw.ca) promotes the human rights of people living with and vulnerable to HIV/AIDS, in Canada and internationally, through research and analysis, advocacy and litigation, public education and community mobilization. The Legal Network is Canada's leading advocacy organization working on the legal and human rights issues raised by HIV/AIDS.